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NORTHEAST ORTHOPEDIC ASSOCIATES PC NPI 1902850357


NPI Information

NPI: 1902850357
Provider Name: NORTHEAST ORTHOPEDIC ASSOCIATES, PC
Classification: Orthopaedic Surgery - 207XS0114X
Entity Type: Organization

Specialization: Adult Reconstructive Orthopaedic Surgery

CLIA Number: 22D2180282

Address:
200 PROVIDENCE HWY
SUITE 202
DEDHAM, MA
ZIP 02026
Phone: (781) 461-4543
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NORTHEAST ORTHOPEDIC ASSOCIATES, PC is an adult reconstructive orthopaedic surgery orthopaedic surgery in Dedham, MA. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. NORTHEAST ORTHOPEDIC ASSOCIATES, PC NPI is 1902850357. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 PROVIDENCE HWY
SUITE 202
DEDHAM, MA
ZIP 02026-881
Phone: (781) 461-4543
Fax: (781) 326-2030

The provider's authorized official is John J Tierney .
The authorized official title is President and has the following contact phone number (781) 461-4543.

The CLIA number assigned to this NPI record is 22D2180282 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 10/11/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XX0005XOrthopaedic SurgerySports MedicineMASSACHUSETTSNo
2207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryMASSACHUSETTSNo
32081P2900XPhysical Medicine & RehabilitationPain MedicineMASSACHUSETTSNo
4208100000XPhysical Medicine & RehabilitationMASSACHUSETTSNo
5213ES0000XPodiatristSports MedicineMASSACHUSETTSNo
6213ES0131XPodiatristFoot SurgeryMASSACHUSETTSNo
7213E00000XPodiatristMASSACHUSETTSNo
8207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryMASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1M21654MEDICARE PINMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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